Tuberculosis of the middle ear and mastoid is more frequent in adults than is generally recognized on account of the difficulty of finding tubercle bacilli in the purulent discharge. In infants and young children the disease extends to nearly all parts of the temporal bone and, because of this, is more serious than in adults. For those who practice in the West, the disease assumes relatively even more importance, because of the number of tuberculous patients who annually come West in search of health.
Judging from a study of the literature, tuberculosis of the middle ear rarely receives the serious consideration that such an important disease deserves. The milder types are easily overlooked, unless the etiology of all cases of suppurative otitis media can be thoroughly studied by a competent bacteriologist. The absence of pain often results in a late examination by an otologist, because patients do not seek